Doctor Name: | MRS. KELLY RAE SANTINE LANDRY |
NPI Number: | 1396868568 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | PT2207 |
Business Practice Address: | 4063 Ginger Dr Suite C Diberville, MS - 395403705 |
Business Phone Number: | 2283540093 |
Business Fax Number: | 2283540094 |
Mailing Address: | 4063 Ginger Dr, Suite C DIBERVILLE |
State: | MS |
Postal Code: | 395403705 |
Phone Number: | 2283540093 |
Fax Number: | 2283540094 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 03/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT2207 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |